<!DOCTYPE html>
<html>
<meta charset="utf-8">
<head th:include="include :: header"></head>
<body class="gray-bg">
	<div class="wrapper wrapper-content ">
		<div class="row">
			<div class="col-sm-12">
				<div class="ibox float-e-margins">
					<div class="ibox-content">
						<form class="form-horizontal m-t" id="signupForm">
							<div class="form-group">
								<label class="col-sm-3 control-label">中心名称：</label>
								<div class="col-sm-3">
									<input id="name" name="name" class="form-control" type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">描述：</label>
								<div class="col-sm-8">
	                               <input id="description" name="description" class="form-control" type="text">
								</div>
							</div>

							<div class="form-group">
								<label class="col-sm-3 control-label">所在城市:</label>
								<div class="col-sm-8">
									<label class="radio-inline">
										<input type="radio" name="cityIn" value="1" checked="checked" /> 洛杉矶
									</label>
									<label class="radio-inline">
										<input type="radio" name="cityIn" value="2" /> 旧金山
									</label>
									<label class="radio-inline">
										<input type="radio" name="cityIn" value="3" /> 西雅图
									</label>
								</div>
							</div>

							<div class="form-group">
								<label class="col-sm-3 control-label">详细地址：</label>
								<div class="col-sm-8">
	                            <input id="address" name="address" class="form-control" type="text">
								</div>
							</div>

							<input type="hidden" name="labelIds" id="labelIds">
							<div class="form-group">
								<label class="col-sm-3 control-label">标签</label>
								<div class="col-sm-8">
									<label th:each="label:${labels}" class="checkbox-inline">
										<input name="label" type="checkbox" th:value="${label.id}"
											   th:text="${label.name}">
									</label>
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">商家介绍：</label>
								<div class="col-sm-8">
									<input id="intro" name="intro" class="form-control" type="text">
								</div>
							</div>

							<div class="form-group">
								<label class="col-sm-3 control-label">套餐价格范围(人民币)：</label>
								<div class="col-sm-8">
									<div class="row">
										<div class="col-md-2">
											<input id="amountFrom" name="amountFrom" class="form-control" type="text">
										</div>
										<div class="col-md-1">
											<label class="col-sm-3 control-label">至</label>
										</div>
										<div class="col-md-2">
											<input id="amountTo" name="amountTo" class="form-control" type="text">
										</div>
									</div>
								</div>
							</div>

							<input type="hidden" name="promiseIds" id="promiseIds">
							<div class="form-group">
								<label class="col-sm-3 control-label">服务承诺</label>
								<div class="col-sm-8">
									<label th:each="promise:${promises}" class="checkbox-inline">
										<input name="promise" type="checkbox" th:value="${promise.id}"
											   th:text="${promise.name}">
									</label>
								</div>
							</div>


							<!-- 联系人信息 -->
							<div class="form-group">
								<label class="col-sm-3 control-label">联系人姓名：</label>
								<div class="col-sm-2">
									<input id="contactName" name="contactName" class="form-control" type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">联系人电话：</label>
								<div class="col-sm-2">
									<input id="contactMobileNo" name="contactMobileNo" class="form-control" type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">联系人微信：</label>
								<div class="col-sm-2">
									<input id="contactWechat" name="contactWechat" class="form-control" type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">联系人邮箱：</label>
								<div class="col-sm-2">
									<input id="contactEmail" name="contactEmail" class="form-control" type="text">
								</div>
							</div>

							<div class="form-group">
								<label class="col-sm-3 control-label">是否实地验证:</label>
								<div class="col-sm-8">
									<label class="radio-inline">
										<input type="radio" name="verifyFlag" value="0" checked="checked" /> 否
									</label>
									<label class="radio-inline">
										<input type="radio" name="verifyFlag" value="1" /> 是
									</label>

								</div>
							</div>


							<!--
							<div class="form-group">
							<label class="col-sm-3 control-label">上传列表图片(最少3张)：</label>
								<div class="col-sm-8">
									<input id="contactMobileNo" name="contactMobileNo" class="form-control" type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">上传实景图片：</label>
								<div class="col-sm-8">
	                               <input id="contactWechat" name="contactWechat" class="form-control" type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">视频：</label>
								<div class="col-sm-8">
	                            <input id="videoFile" name="videoFile" class="form-control" type="text">
								</div>
							</div>
							-->

								<div class="form-group">
								<div class="col-sm-8 col-sm-offset-3">
									<button type="submit" class="btn btn-primary">提交</button>
								</div>
							</div>
						</form>
					</div>
				</div>
			</div>
	</div>
	</div>
	<div th:include="include::footer"></div>
	<script type="text/javascript" src="/js/appjs/usabb/maternityBase/add.js">
	</script>
</body>
</html>
